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technology if it were financially feasible. The technology is expensive — the
units costs about $400,000, per-click charges run several hundred dollars and
annual maintenance fees can add up.
Of course, facilities can negotiate different payment arrangements with manu-
facturers to cover the cost of the technology. They can lease the units or defer
the start-up costs by securing the units free of charge and paying for the dispos-
ables used during each case — all of the laser systems require case packs con-
taining syringes and the cone-shaped attachment. Partnering with an outsourc-
ing company that sets up mobile units in your facility is another low-cost alter-
native for adding the technology.
Medicare won't reimburse directly for the use of the laser, but as with premi-
um IOLs, facilities are allowed to upcharge patients for astigmatism-correcting
surgery.
How much patients are willing to pay depends on your local market. In gener-
al, you can expect patients to pay a couple thousand dollars for vision upgrades.
My facility in Beverly Hills might have more success finding a sufficient volume
of willing patients than a small center in the Midwest, but for facilities that can
tap into the right population, there's money to be made in lasers.
Can surgeons use the laser on patients who don't have astigmatisms? Sure, if
they find a way to pay for it — notably by implanting a premium lens. They can
certainly incorporate the cost of the laser in the extra $2,000 or so a patient
might be willing to spend for a multi-focal or toric implant. OSM
Dr. Salz (
d rjjsa lz@g ma il.com
) is an ophthalmologist at Los Angeles Lasik Eye
Surgery in California.
O P H T H A L M O L O G Y
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